屏气功能磁共振评价神经胶质瘤患者脑血管反应性的研究  

Evaluation of cerebrovascular reactivity in patients with glioma by breath-hold f MRI

作　　者：戚乐[1] 张寒[2] 丁建平[1] 徐海松[3] 王子荣[1] 张迪[4] 

机构地区：[1]杭州师范大学附属医院放射科,浙江杭州310015 [2]杭州师范大学认知与脑疾病研究中心,浙江杭州310018 [3]杭州师范大学附属医院神经外科 [4]杭州师范大学医学院,浙江杭州310018

出　　处：《中华全科医学》2016年第2期172-175,263,共5页Chinese Journal of General Practice

基　　金：国家自然科学基金(81201156);浙江省医药卫生一般研究计划项目(2013KYB211);杭州市卫生科技计划项目(2014A15);浙江省大学生科技创新活动计划项目(2013R421031)

摘　　要：目的 利用屏气功能磁共振成像（BH-f MRI）评价神经胶质瘤患者的脑血管反应能力（CVR）,帮助神经外科医师脑肿瘤术前规划。方法 对8名神经胶质瘤患者（男性5名,女性3名;年龄18-53岁,平均33.4岁）进行静息态和屏气任务的f MRI研究。采用SPM8软件对f MRI数据进行预处理（P〈0.05,FDR校正）,采用AFNI软件计算肿瘤异常信号区域和对侧镜像正常脑组织BOLD信号变化百分比（PSC）,方差分析两者ROI的信号变化差异,对照分析静息态f MRI定位的脑功能像和BH-f MRI CVR像。结果 独立成分分析（ICA）不仅能够全面揭示运动功能区的位置,而且能够很好地显示肿瘤组织周边的不同功能系统。BH-f MRI CVR像显示神经胶质瘤异常信号区域较对侧镜像正常脑组织的BOLD信号明显下降（P〈0.05）,并与静息态f MRI的BOLD信号阴性区存在交集。结论 静息态f MRI的ICA对肿瘤组织周边的功能系统把握较为全面、准确。BH-f MRI是一种可靠的、简便易行的CVR评价方法,可以提示神经血管耦合障碍（NVU）现象,发现f MRI功能定位的假阴性区,为脑肿瘤外科手术计划的制定和术后风险的判断提供重要参考。Objective To evaluate the cerebrovascular reactivity of patients with glioma by breath-hold fMRI and plan the safest surgical trajectory. Methods Eight patients with glioma （five male and three female;ages 18 to 53 years old,average 33.4 years） were performed the fMRI with resting-state and breath holding task. SPM8 was applied in data processing （P 〈 0.05, FDR correction） ,AFNI was used to calculate the percentage of signal change of BOLD in the tumor regional and contralateral normal brain tissue. The difference of the signal change in two ROI was analyzed. The resting-state fMRI （R-fMRI） mapping and BH fMRI CVR mapping was compared. Results Independent component analysis （ICA） was not only able to reveal the location of the motor function area, but also can display the different functional systems around the tumor tissue. Relative to the mirror side normal brain parenchyma, BH BOLD signal around glioma was significantly decreased （P 〈 0.05 ）, and there was the intersection of the negative region of BOLD signal in R-fMRI. Conclusion ICA of R-fMRI was more comprehensive and accurate in the function system of tumor tissue. BH-fMRI was a convenient and reliable method for CVR assessing to suggest the phenomenon of NVU, and to find false negative areas of fMRI function mapping. It could provide important reference for the formulation of brain tumor surgical plan and the judgment of risk after operation.

关 键 词：神经胶质瘤 脑血管反应能力 功能磁共振成像 

分 类 号：R730.264[医药卫生—肿瘤] R445.2[医药卫生—临床医学]